After a major flu vaccination campaign, an agency bills a private insurance company for the administration of each vaccination according to the insurance company's reimbursement guidelines. This is an example of which major payment method?
Charges
Contractual allowance
Prospective reimbursement
Cost-based reimbursement
The Correct Answer is A
A. Charges refer to the fees billed for services rendered, which in this case is the administration of each vaccination according to the insurance company's guidelines.
B. Contractual allowance refers to the difference between the billed amount and the amount agreed upon in the contract with the insurance company, which is not the primary focus here.
C. Prospective reimbursement is based on predetermined rates rather than charges billed after services are provided.
D. Cost-based reimbursement is determined by the actual costs incurred in providing services, which does not apply in this context as the billing is based on set charges for vaccinations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Allowing the employee to express their opinions both orally and in writing promotes open communication and helps the manager understand the employee's perspective.
B. Inquiring about the employee's personal life may lead to discomfort and does not directly relate to job performance unless the employee chooses to share this information voluntarily.
C. Maintaining a relaxed and professional manner helps create a supportive environment for the appraisal, allowing for a more productive discussion.
D. Setting follow-up dates is important to monitor progress and ensure that the employee is supported in improving performance.
E. Focusing on specific examples only for poor performance can be unbalanced; it is also important to recognize strengths and areas of good performance.
Correct Answer is C
Explanation
A. This question is more about self-assessment and does not require the candidate to provide a specific example of past behavior.
B. While this question addresses conflict resolution, it does not delve into a specific past experience or behavior.
C. This question specifically asks the candidate to describe a past situation, their actions, and the outcomes, making it a classic behavioral question that provides insights into their experiences and conflict management skills.
D. This question is hypothetical and does not focus on the candidate's actual past behavior or experiences.
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